ADDICTION & MENTAL HEALTH

1. ADDICTION & MENTAL HEALTH NATIONAL CO-ORDINATOR

2. National Co-ordinator • Advise • Intervene • Assess • Treatment Pathway • Monitor • Support • Case-manage • Educate

3. Data • October 2008 – December 2011 • Total number of enquiries: 261 • Caseload: 89

4. DHSP Ongoing Figures

5. Chart to show the number of enquiries and new patients between 1st Jan and 31st Dec 2011

6. Chart to show the gender of patients between 1st Oct 2008 and 31st Dec 2011

7. Chart to show the age ranges of patients between 1st Oct 2008 and 31st Dec 2011

8. Chart to show the diagnoses of patients between 1st Oct 2008 and 31st Dec 2011

9. PHASE ONE: THE DREAM • Our dream of helping people emerges early, perhaps in childhood • We imagine the good work we will do • This dream sustains us through our education • However, eventually we must ‘wake up’… • Eventually…we enter reality

10. PHASE TWO: THE START • We start our careers! • We are ready to make the world a better place! • We KNOW we can make a difference! • We realise that our efforts will ease the plight of patients • Our enthusiasm overflows: we live the cause!

11. PHASE THREE: DESPERATELY SEEKING RHYTHM • We begin to recognise the need to pace ourselves • We need to sustain our sanity, health, and energy level • So we slow down, look around, and hopefully devise a plan • We will either take steps to move forward… • …or, we will check out and leave the profession

12. PHASE FOUR: FINDING OUR RHYTHM • We successfully find our pace, our niche, our way • This discovery is thrilling and provides a sense of relief • We begin to hit a stride that carries us through • We know better what to expect of our career… • …and we have previous successes to draw from!

13. TOP STRESSORS FOR DENTISTS • Difficult or non-compliant patients • Not enough time (specifically to devote to patient care) • Challenge to meet targets • Problems with staff performance • Concern about skills/accuracy • Lack of sufficient trained staff • Problems with co-workers • Others (e.g. noise, computer problems)

14. TOP SATISFIERS FOR DENTISTS • Helping patients • Thankful patients • Working as a team • Using skills/learning new ones • Daily contact with patients • Educating patients • Financial rewards

15. Types of Addiction • Alcohol • Drugs • Food • Sex • Money

16. Substance Abuse • DSM-IV Criteria: • Intermittent or persistent pattern of substance use resulting in negative consequences in any or all of the following areas: • Psychological and physical health • Interpersonal relationships • Social status • Financial Status • Legal status • Professional status

17. EVIDENCE OF ADDICTION • Tolerance evidenced by the need to have more to experience the effect or markedly diminished effect with continued use of the same amount. • Withdrawal manifested by either a characteristic withdrawal syndrome for the substance or the same or closely related substance is taken to relieve or avoid withdrawal symptoms.

18. EVIDENCE OF ADDICTION • Use in larger amounts or over a longer period of time than intended • Desire or unsuccessful efforts to cut down or control substance use • A great deal of time is spent in activities necessary to ensure source of supply • Important activities given up or reduced because of substance use

19. SUBSTANCE DEPENDENCE • The essential feature of Substance Dependence is a cluster of cognitive, behavioural and physiological symptoms indicating that the individual continues to use the substance despite significant substance related problems.

20. MOOD DISORDERS/ADDICTION • Substance abuse often leads to mood disorders characteristic of such disorders. Including Psychosis, affective disorders [depression, anxiety, mania, bi-polar] obsessive compulsive disorder and sleep disorders

21. MOOD DISORDERS/ADDICTION • Treating the Addiction often relieves the Mood Disorder • Addicts often prefer a psychiatric diagnosis to accepting their addiction

22. TREATMENT • Addiction is a treatable illness • Admit • Accept • Act

23. Mental Health • 1 in 4 experience a mental health problem in their lifetime • The most common disorders are affective disorders e.g. depression, anxiety, stress and bipolar disorder • There is a higher than average incidence of suicide among dentists

24. DSM-IV Criteria for Anxiety • The anxiety disorders are a group of conditions characterised by the presence of excessive worry, fear or dread, tension, or arousal that causes marked distress or clinically significant impairment in functioning.

25. DSM-IV Criteria for Depression • Major depressive episode symptoms include change in motor agitation or retardation, inappropriate guilt, complaints or evidence of diminished ability to concentrate, nocturnal and diurnal variation in mood, loss/excess of appetite, sleep disturbance and recurrent thoughts of death or suicide.

26. DSM-IV Criteria for Manic Depression • The essential features of a manic episode are euphoric mood, excessive level of energy and decreased need for sleep. The euphoria may be transient and followed by irritability. Self-esteem is often inflated, with the individual believing that he or she has great talents or special knowledge. The individual’s speech is often loud and difficult to interrupt, and his or her thoughts are characterised by distractibility and moving rapidly from one subject to another (flight of ideas). There may be excessive involvement in activities or impulsive, capricious behaviour such as spending money, taking unexpected trips, or exhibiting inappropriate sexual behaviour.

27. Contacts • Email: rory.oconnor4@btinternet.com • Telephone no: 0207 224 4671 • Mobile: 07725 972866